Informative Bulletin in the ICU: perception of family members and health professionals

Abstract

In the daily routine of the intensive therapy, the patient’s family is anxious, afraid of their loss, of the unknown. This situation is more critical when they have to face a health unit with limited access due to strict schedule. Among the guidelines of most Intensive Care Units (ICU), there is the clinical information about the patients, provided to the family through an Informative Bulletin (IB) containing terms such as severe, stable, regular, which do not satisfactorily enlighten them as to the condition of their relative. It is common for the family to receive the IB and still search for additional information by telephone or personally. It is a descriptive exploratory study with the purpose of to identify similarities and differences among various Informative Bulletins (IBs) of Intensive Care Unity (ICU) and the routine of information to the family members in the ICUs; to describe the family members and health professionals’ perception about the IB as an instrument to communicate the clinical state of the ICU patient; to identify the communication aspects involved in the comprehension of the ICU Informative Bulletin by the professionals and family members; to identify suggestions given by the professionals and family members in order to create suitable IBs to the family members’ needs. The participants were 41 professionals and people with a family member under treatment in an ICU. Data were collected through semi structured interviews followed by answer content analysis in accordance with Bardin (2004). Comparison between information routine of each ICU and the various IBs indicated that they are similar both in form and content. Most participants characterized the IB as not clear and containing technical terms, not elucidative about the condition of the patient, generating confusion and doubts about the information reliability. They also considered it subjective and controversial due to lack of consensus criteria on the terms used. Some participants mentioned that the IB is an effective way to transmit information and reach the family member perception because it is simple and there are ethical aspects that limit its content. They also emphasized the importance of the inclusion of other not technical items with a glossary. It was possible to identify similarities in the discourses of the professionals and family members and a professional practice that did not correspond to the discourse. This leads to the reflection that a change is vital both in form and content used in the IBs, and that it is necessary to revise some routine ways of thinking and acting. This presumes the understanding that the assistance service excellence, based on effective communication, involves reorganizing the process of work in the theoretical, practical, political, organizational, and interpersonal dimensions. Nevertheless, this process of change is more dependent on personal changes than on external ones, because the quality of the assistance involves not only the technical act, but mainly the human dimension, which certainly derives from the interaction, the effective dialogue, the respect to the diversity of perceptions, the changes in behavior. It means to transform the discourse of “attention with quality” into action.

Key words: Nursing; Intensive Care Unity; Communication.